Savannah Anderson

Individual provider Active NPI Behavior Analyst · Saint Marys, GA

NPI 1104331552 · NPPES record last updated Jan 24, 2022

Key facts

NPI
1104331552
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-21-53069 (GA)
Practice address
107 Industrial Dr Ste E
Saint Marys, GA 31558-4436
Phone
(904) 538-0713
Fax
(904) 538-0714
NPI assigned
Dec 7, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-30465
Behavior Analyst 103K00000X 1-21-53069 GA Yes

Addresses

Primary practice location

107 Industrial Dr Ste E
Saint Marys, GA 31558-4436

Mailing address

10175 Fortune Pkwy Unit 903
Jacksonville, FL 32256-6755
Phone (904) 538-0713

Other providers in Saint Marys, GA

All providers in Saint Marys, GA · Behavior Analyst in Georgia

Sources for this page

Verify at the official NPI Registry.